Value of rest-stress myocardial positron tomography using nitrogen-13 ammonia for the preoperative prediction of reversible asynergy

Journal Article · Tue Aug 01 04:00:00 EDT 1989 · Journal of Nuclear Medicine; (USA)

OSTI ID:5546308

Tamaki, N; Yonekura, Y; Yamashita, K; Senda, M; Saji, H; Konishi, Y; Hirata, K; Ban, T; Konishi, J ^[1]

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1. Kyoto Univ. Faculty School of Medicine (Japan)

To determine the predictive value of stress (13N)ammonia positron emission tomography (PET) for reversible ischemia, 31 patients with coronary artery disease underwent rest-stress (13N)ammonia PET before and after coronary artery bypass surgery. The circumferential profile analysis was applied to determine the presence of transient defect (TD) and persistent defect (PD) preoperatively, and the fate of perfusion abnormality and asynergy after the surgery was assessed. Preoperative PET demonstrated 100 segments with perfusion abnormalities, including 69 TD and 31 PD. Fifty-six of the 69 TD (81%) improved in regional perfusion, while only four of 31 PD (13%) improved in perfusion postoperatively (p less than 0.001). Of 75 segments showing regional asynergy on contrast or radionuclide ventriculography preoperatively, 34 of 48 segments with TD (71%) improved in asynergy, while only five of 27 segments with PD (19%) improved in asynergy postoperatively (p less than 0.001). Stress-delayed 201TI tomography was performed in 22 of them. The predictive values for improvement in perfusion (77%) and asynergy (65%) were similar as those by (13N)ammonia PET (81% and 71%, respectively). However, the predictive values for no improvement in perfusion and asynergy by 201TI tended to be low (66% and 58%, respectively), as compared to those in 13N ammonia PET (87%; p less than 0.05 and 81%; p = 0.09, respectively). We conclude that an accurate prediction of reversible ischemia and asynergy can be achieved with rest-stress (13N)ammonia PET. Particularly, it can identify irreversible areas more accurately than the commonly performed stress-delayed 201TI imaging.

• OSTI ID: 5546308
• Journal Information: Journal of Nuclear Medicine; (USA), Journal Name: Journal of Nuclear Medicine; (USA) Vol. 30:8; ISSN 0161-5505; ISSN JNMEA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ACCURACY
AMMONIA
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
CONTRACTION
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
EXERCISE
HEART
HEAVY NUCLEI
HYDRIDES
HYDROGEN COMPOUNDS
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LIGHT NUCLEI
MINUTES LIVING RADIOISOTOPES
NITROGEN 13
NITROGEN COMPOUNDS
NITROGEN HYDRIDES
NITROGEN ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PERFUSED ORGANS
POSITRON COMPUTED TOMOGRAPHY
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
TOMOGRAPHY